Pathophysiology of heavy menstrual bleeding
- PMID: 26695831
- PMCID: PMC5779569
- DOI: 10.2217/whe.15.81
Pathophysiology of heavy menstrual bleeding
Abstract
Heavy menstrual bleeding (HMB) is a common gynecological complaint with multiple etiologies and diverse pathophysiological origins. This review discusses HMB with reference to the recently proposed PALM-COEIN classification system for abnormal uterine bleeding, initially describing the endometrial events in normal menstruation followed by discussion of the perturbations of normal endometrial shedding that can result in HMB. Our present understanding of the mechanisms of menstrual bleeding as well as many of the pathological aberrations of HMB is incomplete. Further research into the pathophysiology of HMB is urgently needed, as clear knowledge of the mechanisms of this disorder will provide new therapeutic targets to formulate more effective treatments.
Keywords: endometrial cancer; endometrial hyperplasia; heavy menstrual bleeding; leiomyoma/fibroid; polycystic ovarian syndrome.
Similar articles
-
Outcome measures for heavy menstrual bleeding.Womens Health (Lond). 2016 Jan;12(1):21-6. doi: 10.2217/whe.15.85. Epub 2015 Dec 23. Womens Health (Lond). 2016. PMID: 26693585 Free PMC article. Review.
-
Systematic review and meta-analysis of the etiology of heavy menstrual bleeding in 2,770 adolescent females.BMC Womens Health. 2024 Feb 20;24(1):136. doi: 10.1186/s12905-024-02921-7. BMC Womens Health. 2024. PMID: 38378571 Free PMC article.
-
Vascular dysfunction as a cause of endometrial bleeding.Gynecol Endocrinol. 2012 Sep;28(9):688-93. doi: 10.3109/09513590.2011.588848. Epub 2012 Jun 12. Gynecol Endocrinol. 2012. PMID: 22686262 Review.
-
Heavy menstrual bleeding.Womens Health (Lond). 2016 Jan;12(1):1. doi: 10.2217/whe.15.71. Womens Health (Lond). 2016. PMID: 26767314 Free PMC article. No abstract available.
-
Ambulatory management of heavy menstrual bleeding.Womens Health (Lond). 2016 Jan;12(1):35-43. doi: 10.2217/whe.15.80. Epub 2015 Dec 23. Womens Health (Lond). 2016. PMID: 26696502 Free PMC article. Review.
Cited by
-
Predictors of response for elagolix with add-back therapy in women with heavy menstrual bleeding associated with uterine fibroids.Am J Obstet Gynecol. 2021 Jan;224(1):72.e1-72.e50. doi: 10.1016/j.ajog.2020.07.032. Epub 2020 Jul 20. Am J Obstet Gynecol. 2021. PMID: 32702363 Free PMC article.
-
Transforming Growth Factor (TGF) β and Endometrial Vascular Maturation.Front Cell Dev Biol. 2021 Apr 9;9:640065. doi: 10.3389/fcell.2021.640065. eCollection 2021. Front Cell Dev Biol. 2021. PMID: 33898426 Free PMC article.
-
Uterine Fibroids and Progestogen Treatment: Lack of Evidence of Its Efficacy: A Review.J Clin Med. 2020 Dec 5;9(12):3948. doi: 10.3390/jcm9123948. J Clin Med. 2020. PMID: 33291422 Free PMC article. Review.
-
Menstrual characteristics and associations with sociodemographic factors and self-rated health in Spain: a cross-sectional study.BMC Womens Health. 2024 Feb 3;24(1):88. doi: 10.1186/s12905-023-02840-z. BMC Womens Health. 2024. PMID: 38310222 Free PMC article.
-
Telomerase and Telomeres in Endometrial Cancer.Front Oncol. 2019 May 17;9:344. doi: 10.3389/fonc.2019.00344. eCollection 2019. Front Oncol. 2019. PMID: 31157162 Free PMC article. Review.
References
-
- Royal College of Obstetricians and Gynaecologists. National menstrual heavy bleeding audit. Second Annual Report. Royal College of Obstetricians and Gynaecologists, London, UK: (2012). www.rcog.org.uk
-
- Weeks AD, Duffy SR, Walker JJ. A double-blind randomised trial of leuprorelin acetate prior to hysterectomy for dysfunctional uterine bleeding. BJOG 107(3), 323–328 (2000). - PubMed
-
- Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO Working Group on Menstrual Disorders FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int. J. Gynaecol. Obstet. 113(1), 3–13 (2011). - PubMed
-
- Jabbour HN, Kelly RW, Fraser HM, Critchley HO. Endocrine regulation of menstruation. Endocr. Rev. 27(1), 17–46 (2006). - PubMed
-
- Hapangama DK, Kamal AM, Bulmer JN. Estrogen receptor beta: the guardian of the endometrium. Hum. Reprod. Update 21(2), 174–193 (2015). - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical